Maternal and Child Health Journal

, Volume 16, Issue 5, pp 1053-1062

First online:

Elective Delivery Before 39 Weeks: The Risk of Infant Admission to the Neonatal Intensive Care Unit

  • Claire A. HoffmireAffiliated withDepartment of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry Email author 
  • , Patricia R. ChessAffiliated withDepartment of Pediatrics, University of Rochester School of Medicine and Dentistry
  • , Taha Ben SaadAffiliated withDepartment of Neonatology, St. Vincent Women’s Hospital
  • , J. Christopher GlantzAffiliated withDepartment of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access


Despite American College of Obstetricians and Gynecologists guidelines suggesting that non-urgent planned deliveries be scheduled at/after 39 weeks; elective delivery before 39 weeks occurs often in the United States. The objective of this study is to estimate the elective delivery rate between 360/7 and 386/7 weeks gestation and compare NICU admission rates between elective and non-elective deliveries. We conducted a retrospective cohort (n = 1,577) study. Charts were reviewed for all singleton deliveries (2006–2007) between 360/7 and 386/7 weeks gestation taking place at one hospital in NYS to determine delivery status. We computed adjusted relative risks (RR) with 95% confidence intervals (CI) for elective delivery in relation to NICU admission using robust Poisson regression. 32.8% of all births were elective: 20.7% of vaginal and 55.7% of cesarean births. Elective delivery increased with increasing gestational age. After controlling for potential confounders, infants born via a vaginal elective delivery (RR = 1.40, CI: 1.00, 1.94), an elective cesarean (RR = 2.05, CI: 1.53, 2.76), or a non-elective cesarean (RR = 2.00, CI: 1.50, 2.66) are at significantly increased risk of NICU admission compared to infants born via a non-elective vaginal delivery. Elective delivery before 39 weeks is common and increases the risk of infant NICU admission.


Elective delivery Non-indicated delivery Non-urgent delivery Neonatal morbidity Scheduled birth